Immunological and bacteriological study on patients with atopic dermatitis

Other Title(s)

دراسة مناعية و بكتريولوجية لمرضى التهاب الجلد التأتبي

Dissertant

al-Qurayshi, Ghadah Muhammad Salih Turki

Thesis advisor

al-Khafaji, Jasim Tumah Husayn
Muslih, Rashid Mahjub

Comitee Members

Flayyh, May T.
al-Jurani, Khidr Hasan Ali
Jumah, Intisar M.
Adhiah, Ali Husayn
Abu Rishah, Rasmiyah Abd

University

University of Baghdad

Faculty

College of Science

Department

Department of Biology

University Country

Iraq

Degree

Ph.D.

Degree Date

2011

English Abstract

A prospective study was conducted to obtain more clarification about the impact of immunological abnormalities on the expression of atopic dermatitis (AD) among Iraqi children patients.

Fifty four cases of AD (30 males and 24 females ), with ages ranging between 3 months to 12 years.

Patients were grouped as 13 mild AD , 30 moderate AD and 11 severe AD according to severity and 18 apparently healthy individuals, 18 psoriasis patient, which both included 9 males and 9 females included as controls.

They were studied using different , immunological and hematological tests, in addition Staphylococcus aureus was isolated and diagnosed.

Furthermore, comparisons were made between the immunological markers in a number of AD conditions.

Atopic dermatitis occur in different ages of childhood.

The percentage of AD patients of the age less than 3 years was the highest (38.4%) , while the lowest was observed at the age 8-12 years (24.6%) .

According to the family history of atopic diseases, there was obvious variation in AD patients with family history in different study groups, specially in the severe AD group (81.8%) followed by the moderate and mild AD groups, (63.3%,53.8%) respectively.

In general (65.5%) of total AD patients had family history of atopic disease such as asthma or eczema.

Atopic dermatitis patients were characterized with increased mean levels of total IgE 186.8 IU/ml compared to healthy controls 35.2 IU/ml and in psoriasis controls 164 IU/ml.

Age had a statistical significance with the mean levels of total serum IgE at (P<0.01).

The highest mean level was observed in the age group of 8-12 years of all study groups and the lowest in the age of less than 3 years .

Total serum IgE levels were not influenced by gender.

Results of the current study also revealed an increased eosinophil count in total AD patients 0.718*109cell/L compared to healthy control and psoriasis controls 0.117*109cell/L, 0.121*109cell/L respectively.

Important findings of this study, was that the mean serum level of IL-12 was statistically increased among Total AD patients (245.6 pg/ml) III compared to healthy control (146.4 pg/ml) and psoriasis controls (180.2 pg/ml).IL-13 level was significantly increased among Total AD patients (17.6 pg/ml), compared to healthy controls (5.5 pg/ml) and psoriasis controls (6.8 pg/ml).

The mean serum IL-18 levels were significantly increased among total AD patients (149.9 pg/ml) , compared to healthy control (47.8 pg/ml) and psoriasis controls (52.8 pg/ml).

Moreover, a significant positive linear correlation was found between IL-18 and each of severity, Total IgE, and IL-12 levels as well as , between IL-12 and both severity and Total IgE.

These results identify IL-12 and IL-18 as mediators in the pathogenesis of AD .

Atopic dermatitis as a disease can be introduced by different aspects including acute and chronic AD, extrinsic and intrinsic AD.

The study revealed a significant increase in the mean total IgE level among acute AD patients (199.2 IU/ml) compared to chronic AD patients(160.9 IU/ml).The mean serum IL-13 level in acute AD patients was significantly higher (21.2 pg/ml) than that of chronic AD patients (11.5 pg/ml) which may indicate a role of IL-13 in elevation of total IgE levels, whereas , IL-12 and IL-18 were decreased in acute AD patients (157.0,118.0 pg/ml) respectively, compared to chronic AD patients (287.8,174.9 pg/ml) respectively .

Extrinsic and Intrinsic AD was an interesting field to investigate the differences between these two patterns of AD.

Results showed highly elevated total IgE levels in the extrinsic group of AD (350 IU/ml) compared to normal and even low total IgE levels in the intrinsic AD group (21 IU/ml).

The mean serum level of IL-13 in extrinsic AD patients 18.4 pg/ml was higher than its level in intrinsic AD patients 16.7 pg/ml with a statistical significance .The mean serum IL-12 and IL-18 were significantly elevated in intrinsic AD patients (248.7, 184.0 pg/ml) respectively, compared to lower levels in extrinsic AD patients (216, 121 pg/ml).

Several autoantibodies have been detected in patients with AD, when ANA were detected in the AD patients of this study it showed that (7.5% )of them were positive for ANA compared to (5.5%) in healthy control and (11.1%) in Psoriasis controls with no statistical significance.

IV The relationship between AD and bacterial colonization was studied.

Skin swabs were taken from AD patients.

Samples were cultured on suitable media for isolation and identification of bacteria.

The results showed that Staphylococcus aureus was the most common isolated bacteria from AD patients with a percentage of (58.3%).

Furthermore, the incidence of S.

aureus in severe AD group was higher (69.0%) than in both moderate and mild AD groups (54.0%, 58.0%) respectively , with a statistical significance at (P<0.01).

These results indicate the role of S.aureus in the severity of AD.

According to gender, the incidence of S.aureus isolates from AD patients in males was higher (62.86%) than that in females (37.14%), compared to healthy controls which was equal in both males and females (50.0%), and Psoriasis controls which was found in females only.

Weather as an environmental factor also played a role in the incidence of S.aureus .

Results showed that its incidence in summer 43.1% was higher than winter (25.5%) with statistical significance at (P<0.05).

Infection with microorganisms have an impact on immunological response, from this point of view it was important to detect the cytokine levels and IgE in the cases of AD patients with S.aureus isolates.

Results showed higher total IgE levels in AD patients with S.aureus isolates than those without isolates , with a statistical significance of (P<0.01).

There was no statistical significance in the IL-18 levels between AD patients with and without S.aureus isolates, while IL-12 and IL-13 was higher in the first group with statistical significance at ( P < 0.01).

In conclusion, the association between AD severity and different immunological markers were assessed.

Acute and chronic AD, extrinsic and intrinsic AD ,are phases of AD disease and are influenced with immunological markers too.

In addition, the persistence of S.aureus was associated with severity of AD disease, and that IL-12,13,and 18 were useful markers to assess AD.

Main Subjects

Medicine

Topics

• Diagnosis

No. of Pages

149

Table of Contents

• APA
• MLA
• AMA

Language

English

Data Type

Arab Theses

Record ID

BIM-598553